“To prevent a heart attack, lower your cholesterol and ......Mar 21, 2017 · and triglycerides (another kind of fat found in food and in your blood) while raising your HDL (often

FOCUS SLIDE

“To prevent a heart attack, lower your cholesterol and take a baby aspirin every day – take it out for jog, then

take it to the gym, then take it for a bike ride . . . . .”

Cholesterol is the Rodney Dangerfield molecule of the human body – “It don’t get no respect”

Cholesterol is so important to bothboth the structure andandfunction of the body, that every cell in your body makes the cholesterol it needs “from scratch” – i.e. you don’t need to get ANY from the food you eat.

The problem is, we love the taste of fat & cholesterol The problem is, we love the taste of fat & cholesterol is an integral part of the fats we eat; and, when we overeat, we take more cholesterol into our body thanour bodies can handle. It’s how our bodies handle the excess cholesterol we take in (a problem our bodies were never supposed to have – if we ate right) that is now the problem.

Besides being part of the membranes in EVERYEVERY cellcell inin ourour bodybody,,cholesterol is the starting material from which numerous hormones are made:

Cholesterol �Pregnenolone � 17a-Hydroxypregnenolone �

Adrenocortical Hormones

Deoxycorticosterone

11-Deoxycortisol

Corticosterone

Aldosterone (a mineralocorticoid) – “sodium conservation hormone”

Cortisol (a glucocorticoid) – “stress hormone”

Female Reproductive Hormones (ovarian) – Estrogens

ProgesteroneProgesterone

17a-hydroxy progesterone

Androstenedione

Estradiole

Estrone

Estriol

Male Reproductive Hormones (testicular) – Androgens

Dehydroepiandrosterone

Androstenedione

Androstenediol

Testosterone

Dihydrotestosterone

(which making animals unique versus other life forms on the planet)cholesterol is the starting material from which numerous hormones are made:

Cholesterol �Pregnenolone � 17a-Hydroxypregnenolone �

Adrenocortical Hormones

Deoxycorticosterone

11-Deoxycortisol

Corticosterone

Aldosterone (a mineralocorticoid) – “sodium conservation hormone”

Cortisol (a glucocorticoid) – “stress hormone”

Female Reproductive Hormones (ovarian) – Estrogens

ProgesteroneProgesterone

17a-hydroxy progesterone

Androstenedione

Estradiole

Estrone

Estriol

Male Reproductive Hormones (testicular) – Androgens

Dehydroepiandrosterone

Androstenedione

Androstenediol

Testosterone

Dihydrotestosterone

Cholesterol is the raw material from which many animal and human hormones are made:

CholesterolCholesterol �Pregnenolone � 17a-Hydroxypregnenolone

AdrenocorticalAdrenocortical “ Hormones“ HormonesCortisol (a glucocorticoid) – “stress management hormone”+ Corticosterone, Deoxycorticosterone, & 11-Deoxycortisol

Aldosterone (“electrolyte management hormone”)�

Female Reproductive Hormones (ovarian) Female Reproductive Hormones (ovarian) –– Estrogens, Etc.Estrogens, Etc.Progesterone, 17a-hydroxy progesterone. Androstenedione,Estradiole, Estrone, Estriol, etc.

Male Reproductive Hormones (testicular) Male Reproductive Hormones (testicular) –– Androgens, Etc.Androgens, Etc.Dehydroepiandrosterone, Androstenedione, Androstenediol, Testosterone, Dihydrotestosterone

THIS IS “COOLER”THIS IS “COOLER” �

AdrenalAdrenalCortexCortex

CholesterolCholesterolfrom the bloodfrom the blood

Synthetic Enzymes

TestisTestis OvaryOvary

(Or are we our own foe?)

Josephine P. Briggs, M.D.Director, N.C.C.I.H. February 20, 2013

Anyone can develop high cholesterol. In fact, ~13% of adult Americans (1 in 8) have the condition, putting them at an increased risk for heart disease. In fact, you can have high cholesterol levels and not even know

A letter from the A letter from the

NCCIH DirectorNCCIH Director

disease. In fact, you can have high cholesterol levels and not even know it - there are no symptoms. The National Heart, Lung and Blood Institute (NHLBI) recommends all adults 20+ to have their cholesterol checked at least every 5 years (more often if your cholesterol levels are elevated).

We know from a National Health Survey, high blood cholesterol is one of the top 10 reasons people turn to complementary health practices and supplements like red yeast rice, flaxseed, and garlic that have been studied for lowering cholesterol. Unfortunately, current research tells us there isn’t conclusive evidence any of these supplements are effective.

But there is some good news. There are steps you can take to lower your cholesterol levels and to protect your health — things like changing your diet, managing your weight, and exercising regularly. For some, taking a cholesterol-lowering drug may also be necessary. Even then, diet, weight management, and exercise can help make a difference.

NHLBI provides resources and tips on how to make heart healthy lifestyle changes through their Therapeutic Lifestyle Changes (T.L.C.) Program(more on this below) - a three-part program that uses diet, physical activity, and weight management for reducing high blood cholesterol.

It’s also important to ask your regular health care provider about proven steps you can take to lower your cholesterol levels. And be sure to talk with them about any complementary health practice you are considering, including dietary supplements. This will help ensure your safe and coordinated care. Take care and be well!

Cholesterol &

Your Coronary Arteries

First, you can’t have Coronary Artery Disease without atherosclerosis First, you can’t have Coronary Artery Disease without atherosclerosis

to clog up the coronary arteries. So, where does that come from? to clog up the coronary arteries. So, where does that come from?

Specialized blood

cells (macrophages)

also work to clean

the artery walls

First, the truth about cholesterol First, the truth about cholesterol –– your body your body

not only not only needsneeds it, your cells make it, SO it, your cells make it, SO

you body doesn’t need it in your dietyou body doesn’t need it in your diet

(but it can’t make less than nothing)

the artery walls

“smooth” blood flow

Specialized blood

cells (macrophages)

also work to clean

“turbulent”

blood flow


also work to clean

the artery walls

High blood sugar levels and nicotine High blood sugar levels and nicotine

((including nicotine from secondincluding nicotine from second--hand smokehand smoke) )

promote plaque formation toopromote plaque formation too..


“turbulent”

blood flow

high risk for

platelet clot

“coronary thrombosis”“coronary thrombosis”

WHAT THEN?

IF THIS HAPPENS IN THE BRAIN � STROKE

About 1 in 8 U.S. adults have high Total Cholesterol which puts them at About 1 in 8 U.S. adults have high Total Cholesterol which puts them at increased risk of having a heart attack. Lowering cholesterol levels can slow down, reduce, and even stop cholesterol build up in the walls of coronary arteries decreasing the risk of an “MI” (Myocardial Infarction) AKA heart attack. Mainstays in lowering cholesterol include: diet, weight loss, physical activity, and appropriate medications (as necessary).

According to the 2007 National Health Interview, high blood cholesterol is a top 10 concern prompting the use of complementary health practices in adults. This class will cover “what the science says” (vs. what the media says) about the effectiveness and safety of popular supplements used by people with high cholesterol such as red yeast rice, flaxseed, and garlic.

“What You Should Do About High Blood Cholesterol”#1.Work with your health care provider. Ask them about proven steps you can take to lower your cholesterol levels. Talk to them about any CAM practices you are considering including dietary supplementsas you develop your plan. This can potentially help you develop a safe, coordinated care plan – i.e. if you are both “on the same page”. [ A doctor will typically talk with you for 5 minutes or so at the end of your appointment if you tell them at the outset you have questions.

Hint – limit yourself to at most 2 quick or 1 longer question ]

Sadly, many healthcare providers – especially those practicing “solo” –Sadly, many healthcare providers – especially those practicing “solo” –DON’T have an “in-house” patient education program or a “Nurse Educator” that teaches patients things a doctor wants them to know and they may not have a “library” of brochures for patients to take home and read. Why? Doctor’s can’t bill for it. Now what?

At this point, patients typically leave, take the Rx given to them by the doctor to the nearest pharmacy to be filled, then go home. They don’t think about their unasked questions until the next appointment - if they even remember what those questions were.

Alternatively, they may take “a class” somewhere (which rare these days) so they know where to go to get answers. CHOICE #2CHOICE #2 ��

“What You Should Do About High Blood Cholesterol”#2. Find a DIFFERENT kind of healthcare provider. Not all medical providers use the “fee for services” model in their medical practice. Some use a “fee for keeping you well” model. These are sometimes called HMO’s – i.e. Health Maintenance Organizations (e.g.–like Kaiser). Ask an HMO about steps you can take to lower your blood cholesterol levels, and they will offer you educational materials and even classes. You can also talk with them about CAM practices that you are considering, including dietary supplements. I’ve found Kaiser most docs open minded and quite knowledgeable.

“What You Should Do About High Blood Cholesterol”#2. Find a DIFFERENT KIND of healthcare provider. Not all medical providers use the “fee for services” model in their medical practice. Some use a “fee for keeping you well” model. These are sometimes called HMO’s – i.e. Health Maintenance Organizations (e.g.–like Kaiser). Ask an HMO about steps you can take to lower your blood cholesterol levels, and they will offer you educational materials and even classes. You can also talk with them about CAM practices that you are considering, including dietary supplements. I’ve found most Kaiser docs open minded and quite knowledgeable.

Kaiser also has a variety of patient education materials on-hand that are freely available to patients. One book I recently found on-line (I don’t know if Kaiser stocks it or not) is –

Your Guide to Lowering Cholesterolwith Therapeutic Lifestyle Changes (TLC)

https://www.nhlbi.nih.gov/health/resources/heart/cholesterol-tlc ��

https://www.nhlbi.nih.gov/health/resources/heart/cholesterol-tlc

Click HERE Click HERE

for a free for a free

downloaddownload

Click HERE Click HERE

for more for more

freebies freebies

this this

goes goes

https://www.nhlbi.nih.gov/health/resourceshttps://www.nhlbi.nih.gov/health/resources

goes goes

for for

pagespages

Heart Risk Calculator – Am College of Cardiology & Am Heart AssociationAm College of Cardiology & Am Heart Association

http://www.cvriskcalculator.com/

I downloaded it ��

If anyone is interested, e-mail me.

“What You Should Know About High Blood Cholesterol”

#1.Work with your health care provider. Ask them about proven steps you can take to lower your blood cholesterol levels. And, talk with them about any CAM practices you are considering, including dietary supplements. This will help ensure safe and coordinated care.



#2. Change your diet. Saturated fat – i.e. animal fat – raises your LDL Cholesterol (AKA bad cholesterol - a major source of cholesterol buildup

and artery blockage) more than anything else you can eat. “Trans fats” ( AKA “hydrogenated vegetable oils” – e.g. Crisco aka “vegetable lard” ) are another significant cause of high blood cholesterol.

READ THE LABELS ON THE STUFF YOU BUY & EAT.READ THE LABELS ON THE STUFF YOU BUY & EAT.READ THE LABELS ON THE STUFF YOU BUY & EAT.READ THE LABELS ON THE STUFF YOU BUY & EAT.



#2. Change your diet. Saturated fat – i.e. animal fat – raises your LDL Cholesterol (AKA bad cholesterol, a major source of cholesterol buildup

and artery blockage) more than anything else you can eat. “Trans fats” ( AKA “hydrogenated vegetable oils” – e.g. Crisco aka “vegetable lard” ) are another significant cause of high blood cholesterol.

#3. Manage your weight. Losing weight may help lowerlower youryour LDLLDL#3. Manage your weight. Losing weight may help lowerlower youryour LDLLDLandand triglyceridestriglycerides (another kind of fat found in food and in your blood) whilewhile raisingraising youryour HDLHDL (often called “good cholesterol,” as it keeps cholesterol from building up in the arteries).




and artery blockage) more than anything else you can eat. Trans fats (AKA hydrogenated vegetable oils) are another main cause of high blood cholesterol. READ THE LABELS ON THE STUFF YOU EAT.


#4. Get moving. Regular physical activity (such as brisk walking 30 minutes each day) can raise HDLcan raise HDL, lower triglycerideslower triglycerides, and also may help you lose weight and lower LDLlower LDL. Aim for 150 min/week.




and artery blockage) more than anything else you can eat. Trans fats (AKA hydrogenated vegetable oils) are another main cause of high blood cholesterol. READ THE LABELS ON THE STUFF YOU EAT.


#4. Get moving. Regular physical activity (such as brisk walking 30 minutes each day) can raise HDLcan raise HDL moremore, lower triglycerideslower triglycerides, and can help you lose weight and lower your LDL. Aim for 150 min/week.

#5. Find out what science says about dietary supplements marketed for improving cholesterol. Red yeast rice, flaxseed, & garlic (among many) have been studied for lowering cholesterol, but there is no conclusive evidence any of these are effective. ��

Red Yeast Rice is a traditional Chinese

culinary product (e.g.- used in making Peking Duck) as well as in “traditional medicinal products” (e.g.–for lowering blood lipid levels including cholesterol). It is made by culturing domestic rice with one of several strains of the yeast Monascus purpureusunder conditions that can vary batch to batch.

Some red rice products (not all) contain chemicals called “monacolins”. One of these (monacolin K) is identical to the cholesterol lowering drug lovastatinincluding side-effects and drug interactions.including side-effects and drug interactions.

There is no way to know how much monacolin K is present in most red yeast rice products if any (so it may or may not work), but that’s a moot point as the FDA has ruled red yeast rice products containing more than trace amounts of monacolin K cannot be sold legally in the U.S. as a dietary supplement. [NOTE: even when medicinal red rice was available, the concentration of monacolin K varied widely from product to product and batch to batch so it was of questionable value.]

Also, red yeast products may contain a contaminant called citrinin which can be nephrotoxic (cause kidney failure), hepatoxic (cause liver failure), or worse – cause chromosomal abnormalities, tumors, and/or death.

Red Yeast Rice – Continued

Even if you find red yeast rice that contains “therapeutic levels” of monacolin K, there are potential side effects to watch out for: – myopathy (muscle symptoms such as pain and weakness) – rhabdomyolysis (a condition in which muscles break down, releasing

myoglobin into the bloodstream that can damage the kidneys), and – liver toxicity (fortunately, there are no known fatal cases),� ALSO

– it should not be used by anyone who is pregnant or breastfeeding.

The risk of rhabdomyolysis may also increase if monacolin K is used The risk of rhabdomyolysis may also increase if monacolin K is used with a variety of drugs including common cholesterol-lowering agents, certain antibiotics, the antidepressant nefazodone, some drugs used to treat fungal infections, and drugs used to treat HIV.

Also, if the process used in culturing red yeast rice is not carefully controlled (as indicated above), citrinin can form which is know to cause kidney failure in lab animals and genetic damage in human cells. In a 2011 analysis of red yeast rice products sold as dietary supplements in the U.S., 4 of the 11 products were found to contain this contaminant. [ NOTE: If you want red yeast rice to lower your cholesterol,

a 1 month supply of generic lovastatin costs about $4.00 if you shop around ]

Flaxseed & Flaxseed Oil have been

used for medical purposes for 2,500 years beginning with Hippocrates in ancient Greece who used them as laxatives. Today, they are still used as laxatives and touted by some proponents for diabetes, cancer, high cholesterol, & hot flashes. I’m not saying thatit works for any of these. (In fact, it hasn’t been proven

to work for any of them.).

There have been a number of human studies on flaxseed and flaxseed oil. Flaxseed doesn’t decrease hot flashes. Preliminary studies are underway looking at flaxseed for ovarian cancer, heart disease, diabetes, asthma, & looking at flaxseed for ovarian cancer, heart disease, diabetes, asthma, & inflammation (nothing learned yet, not that I expect it). In 2009 though, a research review found flaxseed lowered cholesterol in people with relatively high levels. NCCIH is also funding some research on flaxseed and cardiovascular disease, but I’m not aware of any results – thus far –despite doing a rather lengthy literature search.

Stay tuned for future results – who knows when.

Other Flax Facts: don’t eat flaxseeds raw –and– flaxseed and flaxseed oil are well tolerated EXCEPT avoid using during pregnancy/when nursing.

Garlic is the edible bulb from a plant in the lily

family. It is traditionally used for health purposes by people in many parts of the world including Egypt, Greece, Rome, China, Japan, and Native Americans. Garlic is used as a dietary supplement for a number of reasons and thought to be of benefit by some for: high cholesterol, high blood pressure, the common cold, and a number of other diseases & conditions.

A great deal of research has been done on garlic, but much of it consists of small, preliminary, or low-quality studies. There’s conflicting evidence about whether garlic lowers cholesterol levels. If so, the effect is small, about whether garlic lowers cholesterol levels. If so, the effect is small, and low-density lipoprotein (LDL) cholesterol (i.e.- “bad cholesterol”) that is linked to increased heart disease risk may not be reduced at all.

Garlic may be helpful for high blood pressure, but the evidence is weak

Some studies indicate certain groups of people who eat more garlic may be less likely to develop stomach and colon cancers. However, garlic in dietary supplement form has not been shown to reduce the risk. The NCI recognizes garlic as one of several vegetables with potential anticancer properties but doesn’t recommend using it for prevention. There’s not enough evidence to show whether garlic is helpful for the common cold (maybe the odor keeps people with colds away).

What Do We Know About Safety?

Garlic is probably safe for most people in the quantities typically eaten in most foods.

Side effects include: garlicky breath and body odor (no surprise) as well as heartburn and upset stomach. These side effects are typically more noticeable with raw garlic. Some people have allergic reactions to garlic.

NOTE: Consuming garlic may increase the risk of bleeding. If you take an anti-coagulant (blood thinner) such as warfarin (Coumadin) or if you need surgery, be sure to tell your health care provider and/or surgeon if you are taking or planning to take any garlic dietary supplements.

Garlic has also been found to interfere with the effectiveness of some drugs, including saquinavir, which is a drug used to treat HIV infection.

Keep in Mind

Tell all of your health care providers about complementary or integrative health approaches you currently use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and effective/safe care.

Cholesterol GoodCholesterol Good

High CholesterolHigh Cholesterol –––––––––– NOTNOT GoodGoodNormal Mild Severe

Artery Atherosclerosis Atherosclerosis

��

Documents

“To prevent a heart attack, lower your cholesterol and ......Mar 21, 2017 · and triglycerides (another kind of fat found in food and in your blood) while raising your HDL (often